title: Risk factors predicting fractures in early postmenopausal women.
abstract: Abstract Few studies exist evaluating fracture prediction in women aged 50-59. Clinical risk factors are important determinants for fracture prediction in younger postmenopausal women since most fractures occur outside the range of an osteoporotic bone mineral density. Although fracture incidence rates in this age group are about one-half of those aged 60-69, considerable costs and loss of quality-adjusted life years are still incurred in this age group. We sought to determine what clinical risk factors would predict subsequent fractures. Questionnaires were mailed out to 546 rural women who underwent osteoporosis screening 8.3 years previously by bone densitometry and a 24-item clinical risk factor assessment. Our survey had a 55% response rate and found that 11.9% of respondents had subsequent fractures. A prior fracture history, self-reported rheumatoid arthritis, and menopause age <40 were significantly associated with subsequent fractures. A logistic regression analyses showed only a prior fracture history and menopause age <or=40 were predictive variables. Although we were unable to associate increased fracture risk in this age group other reported risk factors of an osteoporotic bone density, FRAX formula, smoking, parity, chronic illnesses, and no hormone replacement during a normal
authors.affiliation: Department of Medicine, West Virginia University School of Medicine, Charleston, USA. apfister@hsc.wvu.edu
authors.forename: Alfred K
authors.initials: AK
authors.lastname: Pfister
authors.forename: Christine A
authors.initials: CA
authors.lastname: Welch
authors.forename: Mary K
authors.initials: MK
authors.lastname: Emmett
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Sheets
mesh_terms: D015502:Absorptiometry, Photon; D015992:Body Mass Index; D015519:Bone Density; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014903:West Virginia / Q000453:epidemiology